MBChB (UCT), DMH(SA)

Dr Ilze Ritter

MBChB (UFS), DMH(SA)

Dr Da-Niel van Zyl

About

RVZ Aesthetics

RVZ Aesthetics represents the vision of two doctors focused on the vast and ever-evolving field of aesthetic medicine. Founded by Dr Ritter and Dr van Zyl who met each other during their community service year at Elizabeth Donkin Psychiatric Hospital. Whilst spending countless hours preparing for their Diploma in Mental Health, they started realizing how a person’s outer appearance can influence their mental well being. Fascinated by this connection they started exploring aesthetic medicine and all it has to offer. Never having looked back, they completed their training courses in Botox and Dermal Fillers (basic and advanced) and look forward to “revitalizing you”, inside and out.

Frequently Asked Questions

This is where you will find most answers. If there should still be any questions left, don't hesitate to contact us.

Botulinum Toxin

When should I start using Botulinum Toxin?

It’s never too early or too late to start using Botulinum Toxin. Since the rise in Botulinum Toxin popularity worldwide, its use has become far more socially acceptable and attainable. People of all ages and gender are now using Botulinum Toxin to not only slow down the aging process, but increasingly as a preventative measure. By inhibiting muscular contraction in a specific area, collagen levels are maintained as opposed to normal aging which results in collagen breakdown through active muscle use. That being said, do not despair if you have lived life to the full and have the wrinkles to show. Botulinum Toxin is effective at reducing the appearance of established fine lines and wrinkles. Remember that Botulinum Toxin does not last forever and best results are seen with regular visits to your aesthetic practitioner.

What is Botulinum Toxin

BTX is a natural purified protein derived from the neurotoxin Clostridium Botulinum Toxin Type A. Although commonly used for cosmetic purposes, Botulinum Toxin has been used for many years in the treatment of various other disorders e.g muscle disorders, spasticity associated with cerebral palsy and other neuromuscular conditions.

How does Botulinum Toxin work?

Botulinum Toxin works by inhibiting muscle contraction at a molecular level. At the junction between the nerve and the muscle, Botulinum Toxin binds to acetylcholine receptors, thereby blocking the action of the chemical messenger, acetylcholine. This process prevents the transmission of a chemical impulse into a muscular contraction. So what does this mean for you? Simply put, Botulinum Toxin prevents communication between the brain and the muscles, resulting in the inability to contract them.

Is it safe?

When used correctly, YES. Botulinum Toxin has been approved for cosmetic use by the FDA after 10 years of extensive research. Botulinum Toxin has become the most commonly used cosmetic treatment due to its proven efficacy, safety record and availability. Aside from its use in the cosmetic field, Botulinum Toxin has been used for more than 20 years in neurology and ophthalmology. Botulinum Toxin should always be administered by a medical practioner who has the necessary training and experience, as well as knowledge of the facial anatomy. When injected by a skilled practioner, side effects and adverse reactions are rare.

What is it used for?

To understand what Botulinum Toxin is used for, one must first understand that there are different types of wrinkles/lines, namely dynamic lines and static lines. Dynamic lines occur during animation and facial expression, while static lines are present even at rest as a result of volume loss. Botulinum Toxin is used for the treatment of dynamic lines such as crow’s feet from smiling and everyone’s favourite frown line…the glabellar line.

Botulinum Toxin is also used for medical treatments, such as bruxism (teeth clenching), migraines and hyperhydrosis (excessive perspiration).

Where can it be injected?

After initial assessment by your doctor, areas of most concern will be identified by evaluating the strength of muscular contraction and extent of wrinkles. Small amounts of Botulinum Toxin will be strategically injected into these problem areas.

Common injection sites include frown lines on the forehead and between the brows, laugh lines around the eyes, nasal wrinkles and down turned mouth corners.

How long does the treatment take?

The actual process of administering Botulinum Toxin is very quick, roughly 5 – 10 minutes. However, provision must be made for consultation and application of topical anaesthetic cream (optional).

How long does the treatment last?

Effects are seen within 3 – 5 days with maximum results in 2 weeks. Botulinum Toxin typically lasts 3 – 6 months, but varies amongst individuals. Factors to take into consideration are age, gender, muscle strength and amount of Botulinum Toxin used. With repeated Botulinum Toxin treatments, the results may last for longer periods, as muscles tend to lose their contracting “memory”.

How do I prepare for the procedure?

Firstly, avoid the procedure if you are allergic to or have had a previous hypersensitivity reaction to Botulinum toxin type A. Also, the procedure should be postponed until any infected or damaged skin has healed. No pre-treatment allergy testing is necessary.

A few days prior to your procedure, avoid any chemicals that may thin your blood and result in excessive bruising and bleeding e.g. alcohol, garlic, aspirin or any other non-steroidal anti-inflammatory drugs.

What can I expect after the procedure?

Post treatment guidelines:

  • For 4 hours avoid lying down and any strenuous activity. If required, make-up may be applied carefully in a manner demonstrated by your practioner.
  • Avoid unnecessary touching, rubbing and extreme expression of the face for 12 – 24 hours, as this may disperse the product into unwanted areas.
  • Alcohol consumption should be postponed to 12 hours after getting Botulinum Toxin

A follow up consultation is usually scheduled after two weeks to assess the efficacy and review for any side-effects.

How much does it cost?

Botulinum Toxin is priced per unit, therefore the total cost depends on the amount used and how many areas are treated.

On average, men need 1.5 times more units than women due to their larger muscle mass.

Please see our Pricelist for further details.

Dermal Fillers

When should I start using fillers?

Ask yourself the following questions…

  • Do I have visible wrinkles that are bothering me?
  • Have these wrinkles become worse/ more prominent?
  • Do I have bags or dark circles under my eyes?
  • Are my lips looking thinner and less plump than before?
  • Have my cheeks lost some of their volume?
  • Do I have prominent naso-labial folds/ smile lines?
  • Am I scared of going under the knife to address my skin concerns?

If ANY of these reside with you… do NOT hesitate to make an appointment with us TODAY!

Prevention, as always, is better than cure.

What are fillers?

Dermal fillers are injectable gel-like substances made primarily of a protein occurring naturally in the body, hyaluronic acid. There are many different types of fillers on the market (e.g. Juvederm™, Restylene™, Perlane), each one varying slightly in their viscosity and the resultant volumising effect. The type used depends on the specific area being treated and practitioner preference.

How do fillers work?

Hyaluronic acid is a protein that occurs in many parts of the body, including the skin, joints and cartilaginous tissue. Its primary function is to act as a shock absorber, working with collagen to add plumpness to the skin and tissues. This natural occurring product decreases with age, resulting in volume loss, skin dehydration and wrinkle formation.

By injecting fillers into areas which have lost volume, they not only create a fuller appearance, but also stimulate fibroblasts to produce more collagen. This natural process of fibroblast stimulation, helps the skin renew itself from within, over and above the actual filler effect.

Is it safe?

Definitely! Dermal fillers are produced by human genes inserted into a bacterium for reproduction. This means that the protein filler is almost exactly the same as the one found in our bodies and therefore has a very low incidence of allergic reactions. No pre-treatment allergy testing is necessary.

Due to the nature of the filler our bodies can break the product down, therefore the effects are not permanent.

What can fillers be used for?

Dermal fillers are used to strategically raise certain areas that have lost their volume and tone, in order to create a fuller and smoother skin appearance. They are injected under the skin and are moulded into place by applying pressure until the desired shape/ look is achieved. Fillers usually set within 3 – 4 days.

Fillers can also be used to contour “harder faces” by softening expression lines, and to reduce dark shadows caused by aging.

Where can it be injected?

After initial assessment by your doctor, areas of most concern will be identified by evaluating the strength of muscular contraction and extent of wrinkles. Small amounts of BTX will be strategically injected into these problem areas.

Common injection sites include frown lines on the forehead and between the brows, laugh lines around the eyes, nasal wrinkles and down turned mouth corners.

How long does the treatment take?

Placement of dermal fillers is a very specific and delicate procedure that should never be rushed. Approximately 45 – 60 minutes should be scheduled for the application of local anaesthetic cream and injection of the fillers.

How long do fillers last?

Depending on which product is used, the duration of effect is between 9 – 18 months.

How do I prepare for the procedure?

Firstly, avoid the procedure if you are allergic to or have had a previous hypersensitivity reaction to a specific dermal filler. Also, the procedure should be postponed until any infected or damaged skin has healed.

A few days prior to your procedure, avoid any chemicals that may thin your blood and result in excessive bruising and bleeding e.g. alcohol, garlic, aspirin or any other non-steroidal anti-inflammatory drugs.

What can I expect after the procedure?

Treatment with dermal fillers is non-surgical and relatively simple; however some tenderness, bruising and swelling may occur. Application of ice packs will help minimize these after effects, which are expected to last only a couple of days following the procedure.

The following should be avoided for the first 24 hours following treatment:

  • Strenuous exercise
  • Excessive sun or heat exposure
  • Applying excessive pressure on the treated areas (including excessive touching and sleeping on the specified areas)
  • Alcohol

The above measures will minimize the risk of temporary redness, bruising and swelling.

How much do fillers cost?

The exact cost will only be known after a consultation with your practitioner, as this will depend on the area being treated, the amount as well as the type of filler used. Various types of fillers may be used during treatment, and costs are calculated according to the volume of filler used, not the number of syringes used. Starting prices are usually from R3 000.

Dermapen 3®

What is the Dermapen 3®?

The Dermapen 3® is a ground-breaking micro-needling device which tightens, lifts and ultimately rejuvenates the skin. It is a small portable pen-like device which consists of two parts: namely, the electric hand piece that plugs into the wall for a source of power; and the disposable needle tip. The disposable tip consists of 12 microscopic needles.
How does it work?
Dermapen 3® works by a process called micro-needling. Micro-needling involves the careful administration of tiny needles into the skin, at varying depths, by means of a handheld device, aka the Dermapen 3®. This device delivers up to 1300 micro-punctures per second into the skin, thereby stimulating the production of collagen and elastin, the major connective tissue components in the skin. By causing micro-trauma to the skin, the body enhances its own re-growth and repair ability, ultimately treating visible signs of aging such as skin atrophy and wrinkles, as well as various types of scarring, stretch marks, pigmentation disorders, skin damage, hair loss and much, much more.

In addition to promoting skin regeneration, it also allows better penetration/ delivery of topical product applied to the skin during or immediately after treatment, increasing effectiveness.

How does it work?

Dermapen 3® works by a process called micro-needling. Micro-needling involves the careful administration of tiny needles into the skin, at varying depths, by means of a handheld device, aka the Dermapen 3®. This device delivers up to 1300 micro-punctures per second into the skin, thereby stimulating the production of collagen and elastin, the major connective tissue components in the skin. By causing micro-trauma to the skin, the body enhances its own re-growth and repair ability, ultimately treating visible signs of aging such as skin atrophy and wrinkles, as well as various types of scarring, stretch marks, pigmentation disorders, skin damage, hair loss and much, much more.

In addition to promoting skin regeneration, it also allows better penetration/ delivery of topical product applied to the skin during or immediately after treatment, increasing effectiveness.

Is it safe?

When done by a qualified practitioner / therapist, then the Dermapen 3® is extremely safe. There is no risk of cross –contamination as the needle shafts are individually sterilized and wrapped, and disposed of after each procedure. Another safety feature is the adjustable needle depth, allowing for a treatment tailored to your own skin’s thickness.

The Dermapen 3® is so advanced that it is safe and suitable to be used in delicate and hard to reach areas such as around the eyes, lips and nose.

Importantly, if you suffer from any chronic skin disorders you must please bring it to your practitioner’s attention prior to any treatment.

Is it painful?

This depends on the needle depth. Minimum needle depths are painless (treatments <0.5mm deep), whereas deeper penetration may be uncomfortable for the patient. However, at RVZ Aesthetics a topical anaesthetic cream will be applied for all Dermapen 3™ procedures, making it virtually pain free.

What is it used for?

Dermapen 3® can be used to treat a variety of skin conditions, including

  • Fine lines
  • Wrinkles
  • Scars (surgical, trauma, burn & acne)
  • Stretch marks
  • Pigmentation
  • Enlarged pores
  • Smoker’s lines (around the lips)
How long does the treatment take?

The duration of the session depends upon the number of areas being treated. It generally takes about 30 to 60 minutes for each session.

How long before I see results?

Typically, you will see a marked improvement after the first treatment itself. Lasting and more significant improvement will be visible after 4-6 treatments, spaced 4-6 weeks apart. The best results will be visible about 6-8 weeks after the treatment when the collagen starts to rebuild. Your skin will continue to improve over the next 6-12 months after a course of treatments, and when combined with the recommended post-treatment care.

How can I prepare for the procedure?

Your skin will be assessed (by a doctor) prior to your first Dermapen 3™ treatment. You may need to prepare your skin with a cream containing active ingredients (e.g. Vitamin A, Vitamin C and procyanidin) for about 2 weeks prior to your Dermapen 3™ treatment to achieve the best results. This allows the skin to build strength, especially in delicate skin areas and speeds up the healing time.

How much does it cost?

Price depends on the area being treated, as well as the indication for treatment.

Prices start from R1500 for full face rejuvenation. Where smaller areas/ scars are treated, the price will be adjusted accordingly.

What can I expect after the procedure?

Generally the area that has been treated will appear red, almost as if sun burnt and feel sensitive for the first 24 hours. It is normal for this last up to 48 hours after treatment.

If immediate return to normal activity is required, a breathable concealer can be applied directly after the treatment to cover any redness.

Slight puffiness and bruising in certain areas is also fairly common but it should all settle within 48 hours. You may also have some peeling of dead skin cells for a few days after the treatment.

It is advisable to avoid any anti-inflammatory medication after treatment, as this may promote unnecessary bleeding. Rather opt for paracetamol if pain medication is needed.

Avoid any direct exposure to the sun for atleast 48 hours post treatment.

First week after treatment, avoid all active creams and serums, and only use the following options:

  • Bioderma Cicabio Arnica is ideal for patients who bruise easily. Use straight afterwards.
  • Neostrata Bionic Serum / Cream / Lotion OR Bio-Hydrating Cream
  • Neostrata Triple Firming Neck Cream OR Collagen Boosting Serum
  • Epimax or SBR Lipocream
  • Skinceutical Hydrating B5 or SkinCeuticals Resveratrol
  • Heliocare or Bioderma sunscreens
Can I get fillers before/after Dermapen 3® treatment?

Yes, these 2 treatments can be combined. Dermal fillers can be injected before or after Dermapen 3® treatment, as long as there is a 7 day rest period between the two.

PDO Threading

What is PDO Threading?

The PDO threading procedure involves using various lengths of thin acupuncture sterile needles to embed PDO dissolving threads deep underneath the surface of the skin. These wires are placed strategically into the dermis, where it acts as a frame for lifting and tightening loose and sagging skin. The material from which these threads are made, Polydioxanone, is a safe substance that keeps the skin in its new tightened state for 4-6 months, whilst also synthesizing new collagen. The lasting result will provide the skin with a fresh, well rested and firmer look whilst supporting new collagen formation for long lasting results.

Are there different types of PDO threads?

Yes, there are different kinds of threads for different complaints. All types of threads result in the following effects:

  • Lifting
  • Skin rejuvenation (tightening and brightening)
  • Wrinkle smoothing
  • Cellulite reduction
  • Angiogenesis – formation of new blood vessels resulting in increased metabolism and blood flow to the treated area

Different types of threads:

  • Monofilament threads:

Effect:  Firming and tightening of saggy, crepey skin

Area:  Face and body skin firming, peri-orbital rejuvenation.

  • Spiral Threads:

Effect: Localized lifting and internal volumizing. Due to the shape of the thread, there is a higher concentration of thread material in the applied area resulting higher collagen production.

Area:  Double chin correction and eye brow lifting.

 

  • Barbed/Cogged threads:

Effect: They are the most powerful option for any body or face area. These threads have bi-directional cogs which serve to lift the skin and smooth out wrinkles when the threads are tightened.

Area:  They are used to generate a Threadlift facelift” by lifting the middle and lower third of the face including lifting of the jawline, “jowls”, neck, cheeks and nasolabial folds

Are they safe?

The methodology of PDO threading has been tried and tested and only qualified medical doctors are authorized to perform this treatment. This procedure is CE approved, and there is no risk of granuloma formation.

The PDO (Polydioxanone) substance the threads are made of is a material increasingly used in general surgery, vascular and cardiac surgery for various sutures. Thus, these threads are listed as a class IV medical device which is absolutely safe, fully absorbent and hypoallergenic. The sutures are also heavy metal free, non allergenic, doesn't trigger immunogenicity mechanisms, has no significant side effects, and inflammatory reaction is very low.

Threads are administered in a sterile environment, making the risk of infection extremely low.

Is it painful?

As local aneasthetic is applied at the insertion points of the needles, this procedure is relatively painless. The level at which the threads are placed is deep in the dermis of the skin, where there are few pain receptors, reducing the level of discomfort.

Which areas can be treated with PDO threads?

Threads are  primarily used in the face, however, they can be inserted in various body parts that require a lift, more than volume restoration.

The following areas are commonly treated with PDO threads:

  • Saggy jawline/ “Jowl’s”
  • Neck firming
  • Improvement of a double chin
  • Marionette lines (lines around the mouth)
  • Nasiolabial folds
  • Cheeks
  • Vermillion border of the lips
  • Crow’s feet
  • Brow lift
  • Other areas: buttocks/ décolletage/ knees/ upper arms etc.
  • How long does the treatment take?

Between 45 – 60 minutes, which allows sufficient time for consultation, application of local anaesthesia and insertion of threads.

How long do results last?

PDO threads give an instant lifting result, with optimum results setting in after about 3 months. The threads dissolve in a natural manner over a course of 6-8months but the rejuvenation and tightening effect of these threads last 1-2 years due to continual collagen stimulation.

How do I prepare for the procedure?

A few days prior to your procedure, avoid any chemicals that may thin your blood and result in excessive bruising and bleeding e.g. alcohol, garlic, aspirin or any other non-steroidal anti-inflammatory drugs.

Note the procedure is be avoided if there is any active skin infection or known auto-immune diseases involving the skin.

What can I expect after the procedure?

Some patient may experience mild swelling, bruising and tightness in the treated area lasting a few hours to a couple of days.

For up to two weeks post procedure, excessive chewing, teeth grinding and gnawing should be avoided e.g. chewing gum.

How much does is cost?

Price varies according the area being treated and type/number of threads used to get the desired effect.

Please see our Pricelist for further details.